1
|
Rothschild CB, Balistreri KA, Mulligan K, Lee KJ, Karst J, Privatt M, Magner K, Lee HJ, Scanlon M, Davies WH. Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences. J Intensive Care Med 2024; 39:159-169. [PMID: 37605433 DOI: 10.1177/08850666231195754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. METHODS Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. RESULTS Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. CONCLUSIONS A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.
Collapse
Affiliation(s)
| | | | - Kathryn Mulligan
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - K Jane Lee
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jeffrey Karst
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Miranda Privatt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristin Magner
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Matthew Scanlon
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - W Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| |
Collapse
|
2
|
Laila A, Gallant M, Bain M, Alexander C, Reis L, Welboren A, von Massow M, Parizeau K, Walton K, Ma DWL, Haines J. Household Food Waste Intervention Is Feasible, Acceptable, and Effective. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:110-117. [PMID: 38325952 DOI: 10.1016/j.jneb.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The primary objective of this study was to assess the feasibility and acceptability of Weeknight Supper Savers, a family-based intervention designed to promote meal preparation and food waste reduction. METHODS The 4-week program was piloted using a single-arm, prepost design. Based on the Theory of Planned Behavior, the intervention included a chef-led online cooking class, a food waste toolkit, and 4 text messages/wk. Postintervention surveys were used to assess the feasibility and acceptability of the interventions. RESULTS Eighteen families (95%) attended their scheduled cooking class. All parents who completed the survey (17 mothers and 12 fathers) reported being satisfied with the overall program, the cooking class, and the toolkit. Approximately 73% of the children (n = 21) reported being satisfied with the overall program, and 77% reported being satisfied with the cooking class and the toolkit. CONCLUSIONS The intervention was feasible and well-received by families. Results could help inform future public health programs focused on reducing household food waste.
Collapse
Affiliation(s)
- Amar Laila
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
| | - Monica Gallant
- Department of Food, Agricultural and Resource Economics, University of Guelph, Guelph, Ontario, Canada
| | - Maggie Bain
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, Ontario, Canada
| | - Chloe Alexander
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, Ontario, Canada
| | - Leticia Reis
- Department of Plant Agriculture, University of Guelph, Guelph, Ontario, Canada
| | - Anna Welboren
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - Mike von Massow
- Department of Food, Agricultural and Resource Economics, University of Guelph, Guelph, Ontario, Canada
| | - Kate Parizeau
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, Ontario, Canada
| | - Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
3
|
Hemrage S, Brobbin E, Deluca P, Drummond C. Efficacy of psychosocial interventions to reduce alcohol use in comorbid alcohol use disorder and alcohol-related liver disease: a systematic review of randomized controlled trials. Alcohol Alcohol 2023; 58:478-484. [PMID: 37530582 PMCID: PMC10493519 DOI: 10.1093/alcalc/agad051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/10/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
This systematic review (PROSPERO CRD42021234598) fills a gap in the literature by assessing the efficacy of psychosocial interventions in patients with alcohol use disorder and alcohol-related liver disease (ARLD), focusing on drinking reduction and abstinence as intervention goals. A systematic search for randomized controlled trials (RCTs) was conducted across various databases. Study screening and data extraction were conducted independently by two reviewers. The data were presented through narrative synthesis. Primary outcomes were alcohol reduction and abstinence at the longest follow-up. Ten RCTs were included, evaluating interventions such as cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), motivational interviewing, or peer support. The total population included 1519 participants. Four studies included a combination of more than one intervention, and two trialed an integrated approach, including medical and psychosocial management. A significant reduction was observed with MET, while abstinence was observed with peer support, MET, and CBT/MET within integrated treatment. The overall certainty of the evidence was moderate. Six studies presented a low risk of bias, one had some concerns, and three were high risk. The findings highlight the potential of psychosocial interventions, with MET being repeatedly associated with improved outcomes. Integrated treatment also demonstrated a promising role in ARLD. Future research should head toward improving the robustness and quality of the evidence. It should also aim to further tailor and trial new psychosocial interventions on this specific clinical population. This will enhance the translation of the evidence into real-world settings.
Collapse
Affiliation(s)
- Sofia Hemrage
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Eileen Brobbin
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Paolo Deluca
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Colin Drummond
- Department of Addictions, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| |
Collapse
|
4
|
Obuobi-Donkor G, Shalaby R, Vuong W, Agyapong B, Hrabok M, Gusnowski A, Surood S, Greenshaw AJ, Agyapong VI. Effects of Text4Hope-Addiction Support Program on Cravings and Mental Health Symptoms: Results of a Longitudinal Cross-sectional Study. JMIR Form Res 2023; 7:e40440. [PMID: 36857114 PMCID: PMC10018381 DOI: 10.2196/40440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/23/2022] [Accepted: 11/11/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Drug misuse is complex, and various treatment modalities are emerging. Providing supportive text messages to individuals with substance use disorder offers the prospect of managing and improving symptoms of drug misuse and associated comorbidities. OBJECTIVE This study evaluated the impact of the daily supportive text message program (Text4Hope-Addiction Support) in mitigating cravings and mental health symptoms in subscribers and quantify user satisfaction with the Text4Hope-Addiction Support program. METHODS Subscribers to the Text4Hope-Addiction Support program received daily supportive text messages for 3 months; the messages were crafted based on addiction counseling and cognitive behavioral therapy principles. Participants completed an anonymous web-based questionnaire to assess cravings, anxiety, and depressive symptoms using the Brief Substance Craving Scale (BSCS), Generalized Anxiety Disorder-7 (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale at enrollment (baseline), after 6 weeks, and after 3 months. Likert scale satisfaction responses were used to assess various aspects of the Text4Hope-Addiction program. RESULTS In total, 408 people subscribed to the program, and 110 of 408 (26.9%) subscribers completed the surveys at least at one time point. There were significant differences between the mean baseline and 3-month BSCS scores P=.01 (-2.17, 95% CI -0.62 to 3.72), PHQ-9 scores, P=.004 (-5.08, 95% CI -1.65 to -8.51), and GAD-7 scores, P=.02 (-3.02, 95% CI -0.48 to -5.56). Participants who received the supportive text messages reported a reduced desire to use drugs and a longer time interval between substance use, which are reflected in 41.1% and 32.5% decrease, respectively, from baseline score. Approximately 89% (23/26) of the participants agreed that Text4Hope-Addiction program helped them cope with addiction-related stress, and 81% (21/25) of the participants reported that the messages assisted them in dealing with anxiety. Overall, 69% (18/26) of the participants agreed that it helped them cope with depression related to addiction; 85% (22/26) of the participants felt connected to a support system; 77% (20/26) of the participants were hopeful of their ability to manage addiction issues; and 73% (19/26) of the participants felt that their overall mental well-being was improved. Most of the participants agreed that the interventions were always positive and affirmative (19/26, 73%), and succinct (17/26, 65%). Furthermore, 88% (21/24) of the participants always read the messages; 83% (20/24) of the participants took positive or beneficial actions after reading; and no participant took a negative action after reading the messages. In addition, most participants agreed to recommend other diverse technology-based services as an adjunctive treatment for their mental and physical health disorders. CONCLUSIONS Subscribers of Text4Hope-Addiction Support program experienced improved mental health and addiction symptoms. Addiction care practitioners and policy makers can implement supportive text-based strategies to complement conventional treatments for addiction, given that mobile devices are widely used.
Collapse
Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | | | | | | | - Vincent Io Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
5
|
Obuobi-Donkor G, Shalaby R, Eboreime E, Agyapong B, Phung N, Eyben S, Wells K, Hilario C, Dias RDL, Jones C, Brémault-Phillips S, Zhang Y, Greenshaw AJ, Agyapong VIO. Text4PTSI: A Promising Supportive Text Messaging Program to Mitigate Psychological Symptoms in Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4215. [PMID: 36901235 PMCID: PMC10001524 DOI: 10.3390/ijerph20054215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Public safety personnel experience various mental health conditions due to their work's complex and demanding nature. There are barriers to seeking support and treatment; hence, providing innovative and cost-effective interventions can help improve mental health symptoms in public safety personnel. OBJECTIVE The study aimed to evaluate the impact of Text4PTSI on depression, anxiety, trauma, and stress-related symptoms, and the resilience of public safety personnel after six months of providing supportive text message intervention. METHODS Public safety personnel subscribed to Text4PTSI and received daily supportive and psychoeducational SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at baseline (enrolment) and six weeks, three months, and six months after enrollment. RESULTS One hundred and thirty-one subscribers participated in the Text4PTSI program, and eighteen completed both the baseline and any follow-up survey. A total of 31 participants completed the baseline survey and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of psychological problems among public safety personnel were as follows: likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of likely MDD, likely GAD, and likely PTSD among respondents reduced; however, a statistically significant reduction was reported only for likely MDD (-35.3%, X2 (1) = 2.55, p = 0.03). There was no significant change in the prevalence of low resilience between baseline and post-intervention. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02). CONCLUSIONS The results of this study suggest a significant reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. Text4PTSI is a cost-effective, convenient, and easily scalable program that can augment other services for managing the mental health burdens of public safety personnel.
Collapse
Affiliation(s)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Natalie Phung
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Scarlett Eyben
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Kristopher Wells
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB T5J 4S2, Canada
| | - Carla Hilario
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Chelsea Jones
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| |
Collapse
|
6
|
Tami-Maury I, Klaff R, Hussin A, Smith NG, Chang S, McNeill L, Reitzel LR, Shete S, Abroms LC. A Text-Based Smoking Cessation Intervention for Sexual and Gender Minority Groups: Protocol for a Feasibility Trial. JMIR Res Protoc 2022; 11:e42553. [PMID: 36485022 PMCID: PMC9789491 DOI: 10.2196/42553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Smoking among sexual and gender minority (SGM) groups, which include lesbian, gay, bisexual, transgender, and queer individuals, has been reported to be highly prevalent. This is attributed to several factors, including minority-specific stress and targeted tobacco marketing. Therefore, this population is at an increased risk for tobacco-related diseases. SMS text messaging programs have been found to be effective for smoking cessation and appeal to traditionally hard-to-reach populations over other interventions. It has also been suggested that targeted and tailored interventions could be more effective among SGM smokers because they can be designed to assure a safe, validating health care environment that enhances receptivity to cessation. OBJECTIVE The aim of this study is to develop SmokefreeSGM, a text-based smoking cessation program tailored to and tested among SGM smokers. METHODS The study consists of three phases, culminating in a feasibility trial. In Phase 1, our research team will collaborate with a Community Advisory Board to develop and pretest the design of SmokefreeSGM. In Phase 2, the tailored text messaging program will be beta tested among 16 SGM smokers. Our research team will use a mixed-methods approach to collect and analyze data from participants who will inform the refinement of SmokefreeSGM. In Phase 3, a feasibility trial will be conducted among 80 SGM smokers either enrolled in SmokefreeSGM or SmokefreeTXT, the original text-based program developed by the National Cancer Institute for the general population. Our research team will examine recruitment, retention, and smoking abstinence rates at 1-, 3-, and 6-month follow-up. Additionally, a qualitative interview will be conducted among 32 participants to evaluate the feasibility and acceptability of the programs (SmokefreeSGM and SmokefreeTXT). RESULTS This study received approval from The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects to begin research on August 21, 2020. Recruitment for the beta testing of SmokefreeSGM (Phase 2) began in January 2022. We estimate that the feasibility trial (Phase 3) will begin in September 2022 and that results will be available in December 2023. CONCLUSIONS Findings from this research effort will help reduce tobacco-related health disparities among SGM smokers by determining the feasibility and acceptability of SmokefreeSGM, an SGM-tailored smoking cessation intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05029362; https://clinicaltrials.gov/ct2/show/NCT05029362. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42553.
Collapse
Affiliation(s)
- Irene Tami-Maury
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Rebecca Klaff
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Allison Hussin
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nathan Grant Smith
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, United States
| | - Shine Chang
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorna McNeill
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorraine R Reitzel
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sanjay Shete
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorien C Abroms
- Milken Institute of Public Health, The George Washington University, Washington, DC, United States
| |
Collapse
|
7
|
Khoddam S, Lotfi R, Kabir K, Merghati-Khoei E. The effect of a tele-educational intervention on modifying dysfunctional sexual beliefs of pregnant women: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:495. [PMID: 35715786 PMCID: PMC9204371 DOI: 10.1186/s12884-022-04773-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND & AIM Some cultural scenarios in pregnancy and childbirth reinforce dysfunctional sexual beliefs that reverse changes in the couple's sexual life. The present study aimed to investigate the effect of education by sending text messages on modifying dysfunctional sexual beliefs in pregnant women. METHODS & MATERIALS This study is a randomized clinical trial, and 82 eligible pregnant women referred to educational-medical centers to receive prenatal care were randomly assigned to intervention or control group. The intervention group received 24 text messages during eight weeks (three text messages per week), and the control group received only routine care. Data was collected through a demographic questionnaire, reproductive profile, Spinner's Dyadic Adjustment Scale (DAS), and dysfunctional sexual beliefs questionnaire. Both groups completed the questionnaires before and one week after the intervention. Independent t-test, paired t-test, and analysis of covariance was used to analyze the data. RESULTS The findings revealed no statistically significant difference in the baseline Dyadic Adjustment mean scores of control (132.4 ± 11.01) and intervention (130.10 ± 10.66) groups. Paired t-test analysis showed that the mean score of dysfunctional sexual beliefs was significantly decreased from (29 ± 7.61) at baseline compared to one week after intervention (10.54 ± 6.97) (p < 0.001). Analysis of covariance test to compare the scores of dysfunctional sexual beliefs in the intervention group (10.54 ± 6.97) and control group (26.80 ± 7.80) showed a statistically significant difference (p < 0.01) with an effect size of 0.67. CONCLUSION This study showed that sending text messages to mobile phones of pregnant women has corrected their dysfunctional sexual beliefs. Therefore, this approach can be used in pregnancy care to promote women's sexual health. TRIAL REGISTRATION Clinical trial registry: IRCT20161230031662N9 .
Collapse
Affiliation(s)
- Shirin Khoddam
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Razieh Lotfi
- Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran. .,Social Determinants of Health Research Center, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran.
| | - Kourosh Kabir
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, 1st Golestan- Eshteraki Boulevard, Baghestan, Karaj, Iran.,Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Effat Merghati-Khoei
- Spinal Cord Injury Research Center (BASIR), Neuroscience Institution, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Timm A, Kragelund Nielsen K, Joenck L, Husted Jensen N, Jensen DM, Norgaard O, Terkildsen Maindal H. Strategies to promote health behaviors in parents with small children-A systematic review and realist synthesis of behavioral interventions. Obes Rev 2022; 23:e13359. [PMID: 34734473 DOI: 10.1111/obr.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/12/2021] [Accepted: 08/21/2021] [Indexed: 11/28/2022]
Abstract
In this systematic review and realist synthesis, we aimed to identify strategies to improve dietary and physical activity behaviors for parents with small children. A systematic literature search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO in July 2021. Included studies had to: (i) target one or both parents with at least one child (0-3 years), (ii) aim to improve diet and physical activity, and (iii) report on diet and physical activity outcomes. Intervention context, delivery, and outcomes were extracted, and behavior change techniques were coded. A program theory was developed, and context-mechanism-outcome configurations were identified. In total, 17 interventions reported in 28 studies (19 effectiveness studies; nine protocols) were included. Nine interventions showed small improvements: in diet (n = 5), physical activity (n = 2), or both (n = 2) in mothers. The realist synthesis revealed three strategies to improve health behaviors: (1) using knowledge and role modelling to improve family dynamics, (2) providing various home-based activities to change home environment, and (3) offering flexible delivery, for example, phone or website-based to increase social support. Future interventions for parents with small children should consider involving the whole family, focusing on home-based and practical components, and offering various delivery modes. The protocol for the systematic review and realist synthesis was registered in Research Registry (registration ID: reviewregistry860) March 30th, 2020.
Collapse
Affiliation(s)
- Anne Timm
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Larke Joenck
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | - Dorte Moeller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ole Norgaard
- Department of Education, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Helle Terkildsen Maindal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
9
|
Cibrian FL, Monteiro E, Ankrah E, Beltran JA, Tavakoulnia A, Schuck SEB, Hayes GR, Lakes KD. Parents' perspectives on a smartwatch intervention for children with ADHD: Rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19. PLoS One 2021; 16:e0258959. [PMID: 34705845 PMCID: PMC8550607 DOI: 10.1371/journal.pone.0258959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/08/2021] [Indexed: 12/01/2022] Open
Abstract
Distance learning in response to the COVID-19 pandemic presented tremendous challenges for many families. Parents were expected to support children's learning, often while also working from home. Students with Attention Deficit Hyperactivity Disorder (ADHD) are at particularly high risk for setbacks due to difficulties with organization and increased risk of not participating in scheduled online learning. This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. We implemented a 6-week pilot study of a Digital Health Intervention (DHI) with ten families. The DHI included a smartwatch and a smartphone. Google calendars were synchronized across devices to guide children through daily schedules. After the sixth week, we conducted parent interviews to understand the use of smartwatches and the impact on children's functioning, and we collected physiological data directly from the smartwatch. Our results demonstrated that children successfully adopted the use of the smartwatch, and parents believed the intervention was helpful, especially in supporting the development of organizational skills in their children. Overall, we illustrate how even simple DHIs, such as using smartwatches to promote daily organization and task completion, have the potential to support children and families, particularly during periods of distance learning. We include practical suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction.
Collapse
Affiliation(s)
- Franceli L. Cibrian
- Fowler School of Engineering, Chapman University, Orange, CA, United States of America
| | - Elissa Monteiro
- School of Education, University of California, Riverside, CA, United States America
| | - Elizabeth Ankrah
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States of America
| | - Jesus A. Beltran
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States of America
| | - Arya Tavakoulnia
- The Children School, Irvine, CA, United States of America
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA, United States of America
| | - Sabrina E. B. Schuck
- The Children School, Irvine, CA, United States of America
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA, United States of America
| | - Gillian R. Hayes
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States of America
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA, United States of America
| | - Kimberley D. Lakes
- Department of Psychiatry and Neuroscience, School of Medicine, University of California, Riverside, CA, United States America
| |
Collapse
|
10
|
Ibeneme SC, Ndukwu SC, Myezwa H, Irem FO, Ezenwankwo FE, Ajidahun AT, Ezuma AD, Nnamani A, Onodugo O, Fortwengel G, Uwakwe VC. Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review. BMC Infect Dis 2021; 21:859. [PMID: 34425789 PMCID: PMC8381579 DOI: 10.1186/s12879-021-06563-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Mobile text reminder (SMS) system is considered a viable strategy for targeting/facilitating healthy behavioural change including adherence to prescribed physical exercises (PE) and medication (antiretroviral therapy-ART) which should improve the quality of life (Qol) in people living with HIV/AIDS(PLWHA). Thus, the literature was appraised for evidence of SMS effectiveness in improving ART and PE adherence behaviours and QoL in PLWHA. Methods Eight databases–AMED, CINAHL, Cochrane Library, EMBASE, EMCARE, Ovid MEDLINE, PsycINFO, and PubMed-were searched up to December 2020, using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol.This review included only randomised control trials (RCTs) investigating the effectiveness of SMS in improving QoL or PE or ART adherence behaviour or a combination of these variables in PLWHA >18 years. Two independent reviewers determined the eligibility of the studies. Data were extracted and the quality of the study was assessed with the Physiotherapy Evidence Database (PEDro) tool. The primary outcomes were ART and PE adherence behaviours while the secondary outcome was QoL. Result A pooled estimate of effect was not calculated due to the heterogeneity of methods and outcome measures. Therefore, a narrative synthesis of ten studies that met the inclusion criteria (n = 1621 participants at study completion) comprising males/females, aged ≥ 18 years, was done. There was a significant improvement in ART adherence behaviour except in three underpowered studies. Only the SMS interventions that were developed using the Starks 3-steps Adherence model was associated with positive outcome. The only study that evaluated QoL was underpowered and reported no significant change while there were no RCTs on PE. Conclusion Effects of SMS intervention trends towards a significant improvement in ART adherence behaviour in PLWHA. It is plausible that SMS reminders developed using the broader framework of the interpersonal health behaviour theory(ies) may have positive outcome. Nevertheless, the observed heterogeneity in the methods/outcome measures warrants a cautious interpretation of the findings. There is a lack/paucity of RCTs and therefore no evidence in support of the effectiveness of SMS intervention in improving PE adherence and QoL. Registration number NPLASY202060016. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06563-0.
Collapse
Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria. .,Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa. .,University of Nigeria Centre for Clinical Trials (UNNCET), Enugu Campus, Enugu, Nigeria.
| | - Sandra C Ndukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Franklin Onyedinma Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Fortune Elochukwu Ezenwankwo
- Division of Exercise Science and Sports Medicine, University of Cape Town/Sports Science Institute of South Africa, Cape Town, South Africa
| | - Adedayo Tunde Ajidahun
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Amarachi D Ezuma
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Amaka Nnamani
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Obinna Onodugo
- Department of Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Gerhard Fortwengel
- Fakultat III, Hochschule Hannover - University of Applied Sciences and Arts, Hannover, Germany
| | - Victor C Uwakwe
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| |
Collapse
|
11
|
Zhou X, Bambling M, Edirippulige S. A mixed-method systematic review of text-based telehealth interventions in eating disorder management. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2021-0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose
Eating disorders (EDs) is a major health condition affecting 9% of the global population and 10% of those with EDs lost their lives as a result. Text-based telehealth interventions (TTIs) seem to provide a low-cost and convenient treatment option; however, the evidence is scarce. This study aimed to synthesize evidence relating to the use of TTIs for the management of EDs.
Design/methodology/approach
Five databases were searched published between January 2020 and May 2019. The authors used keywords relating to telehealth and EDs. The authors used Joanna Briggs Institute's (JBI's) critical appraisal instrument to assess the methodology quality of included studies.
Findings
Fifteen studies were included in this mix-method systematic review and assessed for methodology quality. Email, web-based texting, text-messaging and online chat room were used as mode for deliver healthcare for patients with EDs. In the treatment phase, all studies (nine studies; n = 860 participants) showed effectiveness (for RCTs) and usefulness (for non-RCT studies). In the aftercare phase (six studies; n = 364 participants), the results regarding the effectiveness of TTIs were mixed. Two studies showed effectiveness whilst four studies did not find statistically significant change of ED outcomes.
Research limitations/implications
The qualities of these studies varied; firstly, 66% (n = 10) of the studies were non-randomized studies (e.g. single-arm trial, case report) with small samples. Moreover, one-fourth (n = 4) of the studies did not use validated instruments or indicate the instrument. Also, half (n = 7) of the studies used TTIs as adjunct to face-to-face treatment or bigger online treatment, it is hard to make conclusion that the changes were due to TTIs' effect. In addition, follow-up rate is not satisfactory, thus results should be interpreted cautiously.
Practical implications
TTIs seem to be promising for management of EDs, particularly in the treatment phase. This provides an important treatment option for health practitioners and people with EDs as an alternative or in adjunct with face-to-face services.
Originality/value
This is the first review to synthesis the use of TTIs for ED management.
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW The European Stroke Organisation published a European Stroke Action Plan (SAP-E) for the years 2018-2030. The SAP-E addresses the entire chain of care from primary prevention through to life after stroke. Within this document digital health tools are suggested for their potential to facilitate greater access to stroke care. In this review, we searched for digital health solutions for every domain of the SAP-E. RECENT FINDINGS Currently available digital health solutions for the cerebrovascular disease have been designed to support professionals and patients in healthcare settings at all stages. Telemedicine in acute settings has notably increased the access to tissue plasminogen activator and thrombectomy whereas in poststroke settings it has improved access to rehabilitation. Moreover, numerous applications aim to monitor vital signs and prescribed treatment adherence. SUMMARY SAP-E with its seven domains covers the whole continuum of stroke care, where digital health solutions have been considered to provide utility at a low cost. These technologies are progressively being used in all phases of stroke care, allowing them to overcome geographical and organizational barriers. The commercially available applications may also be used by patients and their careers in various context to facilitate accessibility to health improvement strategies.
Collapse
|
13
|
Ku EJ, Park JI, Jeon HJ, Oh T, Choi HJ. Clinical efficacy and plausibility of a smartphone-based integrated online real-time diabetes care system via glucose and diet data management: a pilot study. Intern Med J 2021; 50:1524-1532. [PMID: 31904890 DOI: 10.1111/imj.14738] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 12/06/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Smartphones have become novel healthcare tools for patients with diabetes. However, it is uncertain whether the smartphone application support system helps in glycaemic control in patients with type 2 diabetes. AIMS To evaluate the efficacy and plausibility of smartphone-based integrated online real-time diabetes care. METHODS Forty patients with type 2 diabetes were randomly assigned to the smartphone-based care (SC) (n = 20) and conventional care (CC) (n = 20) groups for 12 weeks. The SC group was instructed to use smartphone application (Noom Coach) and a glucose meter, and was provided medical supervision based on blood glucose level and food intake information sent to the central database server. The efficacy was evaluated by glycated haemoglobin (A1C ≤ 6.5%). The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was collected at baseline and at week 12. RESULTS Seventeen and 18 patients of the SC and CC groups completed the study respectively. In the SC group, more patients achieved target A1C compared with the CC group (47.1% vs 11.1%, P = 0.019). In both group, SDSCA scores excluding the exercise item showed overall improvement (general diet, 1.4 ± 2.0 → 2.6 ± 2.3 vs 0.4 ± 1.1 → 1.8 ± 2.2; specific diet, 4.2 ± 1.7 → 5.4 ± 1.2 vs 3.8 ± 1.6 → 5.1 ± 1.1; blood glucose test, 3.3 ± 2.8 → 4.9 ± 2.3 vs 1.0 ± 2.2 → 4.7 ± 2.3; foot care, 1.5 ± 1.6 → 3.6 ± 2.8 vs 1.4 ± 1.9 → 6.1 ± 1.4; all P < 0.05). There was no difference between both groups other than the aspect of foot care (P = 0.008). CONCLUSIONS The smartphone-based integrated online real-time diabetes care system through glucose and diet data management showed clinical plausibility in glucose control in real clinical practice.
Collapse
Affiliation(s)
- Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Ji-In Park
- Department of Anesthesiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Hyun Jeong Jeon
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Taekeun Oh
- Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Hyung Jin Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
14
|
Ybarra M, Goodenow C, Rosario M, Saewyc E, Prescott T. An mHealth Intervention for Pregnancy Prevention for LGB Teens: An RCT. Pediatrics 2021; 147:e2020013607. [PMID: 33568491 PMCID: PMC7924142 DOI: 10.1542/peds.2020-013607] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although lesbian, gay, bisexual and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence, relevant pregnancy prevention programming is lacking. METHODS A national randomized controlled trial was conducted with 948 14- to 18-year-old cisgender LGB+ girls assigned to either Girl2Girl or an attention-matched control group. Participants were recruited on social media between January 2017 and January 2018 and enrolled over the telephone. Between 5 and 10 text messages were sent daily for 7 weeks. Both experimental arms ended with a 1-week booster delivered 12 weeks subsequently. RESULTS A total of 799 (84%) participants completed the intervention end survey. Participants were, on average, 16.1 years of age (SD: 1.2 years). Forty-three percent were minority race; 24% were Hispanic ethnicity. Fifteen percent lived in a rural area and 29% came from a low-income household. Girl2Girl was associated with significantly higher rates of condom-protected sex (adjusted odds ratio [aOR] = 1.48, P < .001), current use of birth control other than condoms (aOR = 1.60, P = .02), and intentions to use birth control among those not currently on birth control (aOR = 1.93, P = .001). Differences in pregnancy were clinically but not statistically significant (aOR = 0.43, P = .23). Abstinence (aOR = 0.82, P = .34), intentions to be abstinent (aOR = 0.95, P = .77), and intentions to use condoms (aOR = 1.09, P = .59) were similar by study arm. CONCLUSIONS Girl2Girl appears to be associated with increases in pregnancy preventive behaviors for LGB+ girls, at least in the short-term. Comprehensive text messaging-based interventions could be used more widely to promote adolescent sexual health behaviors across the United States.
Collapse
Affiliation(s)
- Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, California
| | | | - Margaret Rosario
- City College and Graduate Center, The City University of New York, New York, New York; and
| | - Elizabeth Saewyc
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Tonya Prescott
- Center for Innovative Public Health Research, San Clemente, California
| |
Collapse
|
15
|
Bunova SS, Zhernakova NI, Fedorin MM, Skirdenko YP, Osipova OA. Effective antihypertensive therapy: focus on adherence management. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
High medical adherence is a prerequisite for achieving goals in the treatment of hypertension (HTN). The majority of patients with HTN showed low adherence to treatment, which requires finding ways to solve this problem. This review describes the factors influencing adherence, ways of its assessment, and analyzes methods of increasing medical adherence in hypertensive patients. Noteworthy is the lack of publications describing the effectiveness of methods for increasing long-term (>2 years) adherence in hypertensive patients. The review also describes a not fully clear individualized approach, which consists in choosing a therapy regimen based on levels of medical adherence, medical follow-up and lifestyle modification.
Collapse
Affiliation(s)
- S. S. Bunova
- National Research University Belgorod State University (BelSU))
| | | | | | | | - O. A. Osipova
- National Research University Belgorod State University (BelSU))
| |
Collapse
|
16
|
Juarascio AS, Hunt RA, Lantz Lesser E, Engel SG, Pisetsky EM, Peterson CB, Wonderlich SA. Enhancing Integrative Cognitive-Affective Therapy with ecological momentary interventions: A pilot trial. EUROPEAN EATING DISORDERS REVIEW 2020; 29:152-158. [PMID: 33104279 DOI: 10.1002/erv.2800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/14/2020] [Accepted: 10/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Although current treatments are effective for some patients with eating disorders, a large number of patients remain partially or fully symptomatic post-treatment. This may be related to poor utilization of treatment skills outside of the therapy office. Smartphone applications that can detect and intervene during moments of need could facilitate such skill use between sessions. METHOD Individuals (N = 16) participated in a small pilot open trial where they received 21 sessions of in-person Integrative Cognitive-Affective Therapy (ICAT) therapy an app (iCAT+) that delivers ecological momentary interventions (EMI) in response to user-entered data. Data were collected on the feasibility and acceptability of this treatment approach and on preliminary indicators of treatment outcomes. RESULTS Participants found iCAT+ as a treatment augmentation acceptable and indicated it had clinical utility as an adjunct to in-person therapy, although analyses indicated poor compliance with data entry needed to trigger EMI delivery. This suggests that long-term use of EMI requiring ongoing data entry is infeasible. CONCLUSIONS We describe lessons learned from our initial pilot trial and future directions for the development of impactful EMI systems that can be used to augment in-person therapies.
Collapse
Affiliation(s)
- Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Rowan A Hunt
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Elin Lantz Lesser
- Sanford Health/Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott G Engel
- Sanford Health/Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen A Wonderlich
- Sanford Health/Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| |
Collapse
|
17
|
Ybarra ML, Price-Feeney M, Prescott T, Goodenow C, Saewyc E, Rosario M. Girl2Girl: How to develop a salient pregnancy prevention program for cisgender sexual minority adolescent girls. J Adolesc 2020; 85:41-58. [PMID: 33038687 DOI: 10.1016/j.adolescence.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 09/05/2020] [Accepted: 09/09/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Although sexual minority girls are more likely than heterosexual girls to be pregnant during adolescence, programs tailored to their needs are non-existent. Here we describe the iterative development of Girl2Girl, a text messaging-based pregnancy prevention program for cisgender lesbian, gay, bisexual and other sexual minority (LGB+) girls across the United States. METHODS Four activities are described: 1) 8 online focus groups to gain feedback about intended program components (n = 160), 2) writing the intervention content, 3) 4 online Content Advisory Teams that reviewed and provided feedback on the salience of drafted intervention content (n = 82), and 4) a beta test to confirm program functionality, the feasibility of assessments, and the enrollment protocol (n = 27). Participants were 14-18-year-old cisgender LGB+ girls recruited nationally on social media. Across study activities, between 52% and 70% of participants were 14-16 years of age, 10-22% were Hispanic ethnicity, and 30-44% were minority race. RESULTS Focus group participants were positive about receiving text messages about sexual health, although privacy was of concern. Thus, better safeguards were built into the enrollment process. Teens in the Content Advisory Teams found the content to be approachable and compelling, although many wanted more gender-inclusive messaging. Messages were updated to not assume people with penises were boys. Between 71 and 86% of participants in the beta test provided weekly feedback, most of which was positive; no one withdrew during the seven-week study period. CONCLUSIONS This careful step-by-step iterative approach appears to have resulted in a high level of intervention feasibility and acceptability.
Collapse
Affiliation(s)
- Michele L Ybarra
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA.
| | - Myeshia Price-Feeney
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA; The Trevor Project, PO Box 69232, West Hollywood, CA, 90069, USA
| | - Tonya Prescott
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA
| | | | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, Vancouver Campus, T222-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Margaret Rosario
- Department of Psychology, The City University of New York, 160 Convent Avenue New York, NY, 10031, USA
| |
Collapse
|
18
|
Cheng CW, Brown CR, Venugopalan J, Wang MD. Towards an Effective Patient Health Engagement System Using Cloud-Based Text Messaging Technology. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2020; 8:2700107. [PMID: 32974110 PMCID: PMC7508315 DOI: 10.1109/jtehm.2018.2868358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 06/09/2018] [Accepted: 08/25/2018] [Indexed: 11/06/2022]
Abstract
Patient and health provider interaction via text messaging (TM) has become an accepted form of communication, often favored by adolescents and young adults. While integration of TM in disease management has aided health interventions and behavior modifications, broader adoption is hindered by expense, fixed reporting schedules, and monotonic communication. A low-cost, flexible TM reporting system (REMOTES) was developed using inexpensive cloud-based services with features of two-way communication, personalized reporting scheduling, and scalable and secured data storage. REMOTES is a template-based reporting tool adaptable to a wide-range of complexity in response formats. In a pilot study, 27 adolescents with sickle cell disease participated to assess feasibility of REMOTES in both inpatient and outpatient settings. Subject compliance with at least one daily self-report pain query was 94.9% (112/118) during inpatient and 91.1% (327/359) during outpatient, with an overall accuracy of 99.2% (970/978). With use of a more complex 8-item questionnaire, 30% (7/21) inpatient and 66.6% (36/54) outpatient responses were reported with 98.1% (51/52) reporting accuracy. All participants expressed high pre-trial expectation (88%) and post-trial satisfaction (89%). The study suggests that cloud-based text messaging is feasible and an easy-of-use solution for low-cost and personalized patient engagement.
Collapse
Affiliation(s)
- Chih-Wen Cheng
- The Wallace H Coulter Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA
| | | | - Janani Venugopalan
- The Wallace H Coulter Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA
| | - May D Wang
- The Wallace H Coulter Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA
| |
Collapse
|
19
|
Simpson SA, Matthews L, Pugmire J, McConnachie A, McIntosh E, Coulman E, Hughes K, Kelson M, Morgan-Trimmer S, Murphy S, Utkina-Macaskill O, Moore LAR. An app-, web- and social support-based weight loss intervention for adults with obesity: the 'HelpMeDoIt!' feasibility randomised controlled trial. Pilot Feasibility Stud 2020; 6:133. [PMID: 32968544 PMCID: PMC7501712 DOI: 10.1186/s40814-020-00656-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background Social support has an important role in successful weight loss. The aim of this study was to assess the feasibility and acceptability of an app-, web- and social support-based intervention in supporting adults with obesity to achieve weight loss. Methods The intervention and evaluation methods were tested in a feasibility randomised controlled trial. Adults in the Greater Glasgow and Clyde Health Board area of Scotland with a body mass index ≥ 30 kg/m2 were recruited and randomised 2:1 (intervention to control). The feasibility and acceptability of the intervention and trial methods were assessed against pre-specified progression criteria, via process, economic and outcome evaluation. Three primary outcomes were explored: BMI, diet and physical activity, as well as a number of secondary outcomes. The intervention group had access to the HelpMeDoIt! intervention for 12 months. This encouraged them to (i) set goals, (ii) monitor progress and (iii) harness social support by inviting ‘helpers’ from their existing social network. The control group received a healthy lifestyle leaflet. Results One hundred and nine participants were recruited, with 84 participants (77%) followed-up at 12 months. The intervention and trial methods were feasible and acceptable. Participants and helpers were generally positive. Of the 54 (74%) participants who downloaded the app, 48 (89%) used it. Interview data indicated that HelpMeDoIt! promoted social support from existing social networks to support weight loss. This support was often given outside of the app. Outcomes were compared using linear regression models, with randomised group, the baseline measurement of the outcome, age and gender as predictor variables. These analyses were exploratory and underpowered to detect effects. However, all pre-specified primary outcome effects (BMI, diet and physical activity) had wide confidence intervals and were therefore consistent with clinically relevant benefits. Objective physical activity measures perhaps showed most potential (daily step count (p = 0.098; 1187 steps [− 180, 2555])) and sedentary time (p = 0.022; − 60.8 min [− 110.5, − 11.0]). However, these outcomes were poorly completed. Conclusions The study demonstrated that a novel social support intervention involving support from participants’ close social networks, delivered via app and website, has potential to promote weight loss and is feasible and acceptable. Trial registration ISRCTN, ISRCTN85615983. Registered 25 September 2014
Collapse
Affiliation(s)
- Sharon Anne Simpson
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR UK
| | - Lynsay Matthews
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR UK
| | - Juliana Pugmire
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Robertson Centre, Boyd Orr Building, Glasgow, G12 8QQ UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment Unit (HEHTA), Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ UK
| | - Elinor Coulman
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park Way, Cardiff, CF14 4YS UK
| | - Kathryn Hughes
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park Way, Cardiff, CF14 4YS UK
| | - Mark Kelson
- College of Engineering, Mathematics and Physical Sciences, School of Mathematics/The Alan Turing Institute, University of Exeter, Harrison Building, Streatham Campus, North Park Road, Exeter, EX4 4QF UK
| | - Sarah Morgan-Trimmer
- Institute of Health Research, College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Simon Murphy
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff School of Social Sciences, Cardiff University, Cardiff, CF10 3AT UK
| | - Olga Utkina-Macaskill
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR UK
| | - Laurence Anthony Russell Moore
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR UK
| |
Collapse
|
20
|
Telephone-Based Reeducation of Drug Administration for Helicobacterpylori Eradication: A Multicenter Randomized Controlled Study. Gastroenterol Res Pract 2020; 2020:8972473. [PMID: 32802048 PMCID: PMC7415080 DOI: 10.1155/2020/8972473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/06/2020] [Accepted: 07/23/2020] [Indexed: 01/06/2023] Open
Abstract
Poor adherence to treatment instructions may play an important role in the failure of Helicobacter pylori eradication. The aim of this study was to evaluate the effects of telephone-based reeducation on 14-day quadruple H. pylori eradication therapy. In total, 162 patients were randomly assigned (1 : 1) to either the intervention group (patients received telephone-based reeducation on the 4th, 7th, and 10th days of the course) or the control group (patients received instructions only at the time of getting the prescriptions). All patients received a 14-day quadruple H. pylori eradication therapy. The primary outcome was the H. pylori eradication rate. The secondary outcomes included the symptom relief rates and the incidence rates of adverse events. Seventy-five patients in the reeducation group and 74 patients in the control group completed the follow-up. The H. pylori eradication rate in the reeducation group was statistically higher than that in the control group (intention-to-treat: 72.8% vs. 50.6%, P = 0.006; per-protocol: 78.7% vs. 55.4%, P = 0.003). However, the symptom relief rates and the adverse event rates in these two groups were not significantly different. Overall, the results from this study suggest that telephone-based reeducation can be potentially applied to improve the H. pylori eradication rate in clinical practice, without significantly increasing the adverse effects.
Collapse
|
21
|
Simpson SA, Matthews L, Pugmire J, McConnachie A, McIntosh E, Coulman E, Hughes K, Kelson M, Morgan-Trimmer S, Murphy S, Utkina-Macaskill O, Moore L. An app-, web- and social support-based weight loss intervention for adults with obesity: the HelpMeDoIt! feasibility RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background
Finding solutions to rising levels of obesity continues to be a major public health focus. Social support has an important role in successful weight loss, and digital interventions can reach a large proportion of the population at low cost.
Objective
To develop and assess the feasibility and acceptability of an application (app), web- and social support-based intervention in supporting adults with obesity to achieve weight loss goals.
Design
Stage 1 – intervention development phase involved three focus groups (n = 10) with users, and think-aloud interviews and field testing with another group (n = 28). Stage 2 – the intervention and evaluation methods were explored in a feasibility randomised controlled trial with economic and process evaluation.
Setting
Greater Glasgow and Clyde, UK.
Participants
Adults with a body mass index of ≥ 30kg/m2 who owned a smartphone and were interested in losing weight were randomised 2 : 1 (intervention : control) and followed up at 12 months. Recruitment took place in April–October 2016.
Interventions
The intervention group had access to HelpMeDoIt! for 12 months. This encouraged them to (1) set goals, (2) monitor progress and (3) harness social support by inviting ‘helpers’ from their existing social network. The control group received a healthy lifestyle leaflet.
Main outcome measures
Data from stage 1 informed the intervention design. Key measures in stage 2 assessed the feasibility and acceptability of the intervention and trial methods against prespecified progression criteria. Three primary outcomes were explored: body mass index, diet and physical activity. Secondary outcomes included weight, waist and hip circumference, social support, self-efficacy, motivation, mental health, health-related quality of life, NHS resource use, participant-borne costs and intervention costs. Qualitative interviews with participants (n = 26) and helpers (n = 9) explored the feasibility and acceptability of the trial methods and intervention.
Results
Stage 1 produced (1) a website that provided evidence-based information for lifestyle change and harnessing social support, and (2) an app that facilitated goal-setting, self-monitoring and supportive interaction between participants and their helper(s). Progression criteria were met, demonstrating that the intervention and trial methods were feasible and acceptable. A total of 109 participants (intervention, n = 73; control, n = 36) were recruited, with 84 participants (77%: intervention, 71%; control, 89%) followed up at 12 months. Data were successfully collected for most outcome measures (≥ 82% completion). Participants and helpers were generally positive, although helper engagement with the app was low. Of the 54 (74%) participants who downloaded the app, 48 (89%) used it twice or more, 28 helpers enrolled via the app, and 19 (36%) participants interacted with their helper(s) via the app. Interview data indicated that HelpMeDoIt! prompted support from helpers that often occurred without the helpers using the app.
Limitations
Early technical problems meant that some participants and helpers had difficulty accessing the app. Ethical constraints meant that we were unable to contact helpers directly for interview.
Conclusions
The HelpMeDoIt! study demonstrated that a weight loss intervention delivered via an app and a website is feasible and acceptable. Progression criteria were met, supporting further evaluation of the intervention.
Future work
To further explore (1) the motivation and engagement of helpers, (2) the programme theory and (3) the effectiveness and cost-effectiveness of the intervention.
Trial registration
Current Controlled Trials ISRCTN85615983.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 3. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Sharon Anne Simpson
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lynsay Matthews
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Juliana Pugmire
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment Unit (HEHTA), Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Elinor Coulman
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Kathryn Hughes
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Mark Kelson
- School of Mathematics, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - Sarah Morgan-Trimmer
- Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Simon Murphy
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff School of Social Sciences, Cardiff University, Cardiff, UK
| | - Olga Utkina-Macaskill
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Laurence Moore
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
22
|
The Effects on Inappropriate Weight for Gestational Age of an SMS Based Educational Intervention for Pregnant Women in Xi'an China: A Quasi-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051482. [PMID: 32106558 PMCID: PMC7084866 DOI: 10.3390/ijerph17051482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 12/21/2022]
Abstract
Background: The aim of this study was to estimate the effects of maternal text messages on inappropriate weight for gestational age (IWGA) in newborns in rural China. Methods: Participants were pregnant women presenting for antenatal care at a Maternal and Child Health Center in Xi’an, China during the 2013–2015 period. In total, 2115 women completed the program with follow-up information included in the final analyses. All mothers were divided into four groups, including (1) a control group that received only a few “Basic” messages, (2) a Care-Seeking (CS) message group, (3) Good Household Prenatal Practices (GHPP) message group, and (4) a group receiving all 148 text messages. The primary outcome was IWGA, including small for gestational age (SGA) and macrosomia (weighing ≥4000g at birth). Multivariable logistic regression using an intent-to-treat estimate was utilized. Results: In total, 19.5% of newborns were IWGA. The risk of IWGA was 23.0% in the control group, 19.6% in the CS group, 18.9% in the GHPP group, and 16.5% in the group with All Texts. Compared to the control group, the odds ratio of IWGA was 0.65 (0.48–0.89) for the group receiving All Texts, which remained statistically significant after performing the Holm-Bonferroni correction. The odds ratio of macrosomia was 0.54 (0.34–0.87) and 0.57 (0.36–0.49) for the Care Seeking message group and the All Texts group, respectively, with statistical significance. Conclusion: A package of free informational text messages, including advice for good household prenatal practices and care seeking, may prevent the inappropriate weight for gestational age through a protective effect on macrosomia. Advice to encourage care seeking in pregnancy may prevent macrosomia among neonates in rural China as well.
Collapse
|
23
|
Soares YKDC, Araújo TMED. Evidences on the effectiveness of text messages in the adherence to antiretroviral therapy in adults. Rev Gaucha Enferm 2020; 41:e20190242. [DOI: 10.1590/1983-1447.2020.20190242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 04/28/2020] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the evidence available in the literature on the effectiveness of text messages in the adherence to antiretroviral therapy in adults. Method: Integrative review. The search for primary studies was carried out in MEDLINE/PubMed, Web of Science, CINAHL, LILACS, and SCOPUS and the sample consisted of 18 studies, in April 2019, with no time delimitation. Results: The synthesis of the evidences indicated that, of the 18 analyzed articles, 11 showed an increase in the adherence rates to antiretroviral therapy and an increase in CD4, after using text messages. Conclusion: Text messages are an important tool for health education and the synthesis of knowledge can help nurses to obtain increasingly substantive adherence rates in relation to antiretroviral therapy.
Collapse
|
24
|
Glowacki EM, Bernhardt JM, McGlone MS. Tailored texts: An application of regulatory fit to text messages designed to reduce high-risk drinking. Health Informatics J 2019; 26:1742-1763. [PMID: 31808717 DOI: 10.1177/1460458219889279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study used the regulatory focus/fit framework to compare the impact of text message wording on college students' drinking behaviors. In this 2 × 3 × 2 pre-test/post-test experiment, participants (N = 279) were randomly assigned to one of the three groups: messages matching regulatory focus (congruent group), messages mismatching regulatory focus (incongruent group), and general health messages (control group). Messages were tailored by regulatory fit (prevention-oriented or promotion-oriented). Mixed factorial analyses of covariance revealed that prevention-oriented individuals who received text messages incongruent with their regulatory focus reported drinking alcohol for more hours and were more likely to consume a higher quantity of drinks than participants in the congruent or control group. These findings suggest that health messages mismatched to a receiver's regulatory focus might exacerbate unhealthy behavior.
Collapse
|
25
|
Szrek H, Gyster V, Darnowsky P, Farias AR. Messaging, monetary incentives, and participation in wellness programs. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2019. [DOI: 10.1108/ijwhm-11-2018-0148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Many companies in the USA have corporate wellness programs but are having trouble encouraging employees to take part in these programs. Even with monetary incentives, many employees do not join. The purpose of this paper is to consider whether timely reminders combined with monetary incentives improve participation in health benefit programs.
Design/methodology/approach
Employees of a large manufacturing company across multiple facilities were encouraged to enroll in a messaging service. Once a week, members received an SMS or e-mail reminder to complete a Health Risk Assessment (HRA) and Health Action Plan (HAP). The authors segmented employees based on prior year health insurance plan choice and HRA participation to analyze current HRA and HAP completion, with and without intervention.
Findings
The intervention increased completion rates 6 percent for subgroups that completed the HRA in the prior year and 34–37 percent for those that did not.
Practical implications
Corporate wellness programs should develop good communication channels with employees. The effectiveness of such programs will depend also on employee engagement.
Originality/value
With better communication, companies could raise participation in corporate wellness programmes and potentially reduce some of the monetary incentives that they currently offer.
Collapse
|
26
|
MacPherson MM, Merry KJ, Locke SR, Jung ME. Effects of Mobile Health Prompts on Self-Monitoring and Exercise Behaviors Following a Diabetes Prevention Program: Secondary Analysis From a Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12956. [PMID: 31489842 PMCID: PMC6753687 DOI: 10.2196/12956] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/08/2019] [Accepted: 07/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background A number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior. Objective This study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality. Methods Of the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests. Results In the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year. Conclusions This study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective. International Registered Report Identifier (IRRID) DERR2-10.2196/11226
Collapse
Affiliation(s)
- Megan M MacPherson
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Kohle J Merry
- Mechatronic Systems Engineering, School of Engineering Science, Simon Fraser University, Surrey, BC, Canada
| | - Sean R Locke
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| |
Collapse
|
27
|
Bunnell BE, Davidson TM, Winkelmann JR, Maples-Keller JL, Ridings LE, Dahne J, Fakhry SM, Ruggiero KJ. Implementation and Utility of an Automated Text Messaging System to Facilitate Symptom Self-Monitoring and Identify Risk for Post-Traumatic Stress Disorder and Depression in Trauma Center Patients. Telemed J E Health 2019; 25:1198-1206. [PMID: 30730263 DOI: 10.1089/tmj.2018.0170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Introduction: Comprehensive monitoring and follow-up after traumatic injury is important for psychological recovery. However, scalable services to facilitate this are limited. Automated text message-based symptom self-monitoring (SSM) may be a feasible approach. This study examined its implementation and utility in identifying patients at risk for mental health difficulties after traumatic injury. Materials and Methods: Five hundred two patients admitted to a Level I trauma center between June 20, 2016 and July 31, 2017 were offered enrollment in a text message-based SSM service. Patients who enrolled received daily text message prompts over 30 days and most participated in a mental health screening 30 days postbaseline. Results: Approximately 67% of patients enrolled in the service; of these, 58% responded to the text messages, with an average response rate of 53%. Younger patients and those with elevated peritraumatic distress were more likely to enroll. Patients with higher levels of mental health stigma, who were White, or had been in a motor vehicle collision were more likely to enroll and respond to text messages once enrolled. Patients' daily ratings of distress detected clinically elevated 30-day mental health screens with high sensitivity (83%) and specificity (70%). Discussion and Conclusions: Text message-based SSM can be implemented as a clinical service in Level I trauma centers, and patient participation may increase engagement in mental health follow-up. Further, it can inform the use of risk assessments in practice, which can be used to identify patients with poor psychological recovery who require additional screening.
Collapse
Affiliation(s)
- Brian E Bunnell
- Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Tatiana M Davidson
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer R Winkelmann
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Leigh E Ridings
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Samir M Fakhry
- Synergy Surgicalists, Reston Hospital Center, Reston, Virginia
| | - Kenneth J Ruggiero
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
28
|
Gipson CS, Chilton JM, Dickerson SS, Alfred D, Haas BK. Effects of a sleep hygiene text message intervention on sleep in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:32-41. [PMID: 29652630 DOI: 10.1080/07448481.2018.1462816] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/14/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To test the effectiveness of a text-message intervention to promote sleep hygiene to improve sleep in young adult college students. PARTICIPANTS A convenience sample of undergraduate students from one Southwestern university (n = 96), 18-26 years old, recruited in August 2015. METHODS A 2-group pretest-posttest experimental design assigned participants to receive biweekly text messages about sleep hygiene or healthy behaviors for 6 weeks. Survey questions addressed sleep knowledge, sleep hygiene, self-efficacy for sleep hygiene, and sleep quality at baseline and posttest. RESULTS Though not significant, sleep quality, sleep hygiene, and sleep knowledge improved in both groups. CONCLUSIONS Self-efficacy for sleep hygiene is a modifiable factor that may serve to improve sleep quality. Sleep quality improved in both groups. Text messaging is a feasible approach to delivering an intervention to promote healthy behaviors among young adults.
Collapse
Affiliation(s)
- Christine S Gipson
- a School of Nursing, The University of Texas at Tyler , Tyler , Texas , USA
| | - Jenifer M Chilton
- b School of Nursing, The University of Texas at Tyler , Tyler , Texas , USA
| | - Suzanne S Dickerson
- c Department Chair for Biobehavioral Health and Clinical Sciences , School of Nursing, The University at Buffalo , Buffalo , New York , USA
| | - Danita Alfred
- d Director of the Institute for Integrated Healthcare, School of Nursing, The University of Texas at Tyler , Tyler , Texas , USA
| | - Barbara K Haas
- e School of Nursing, Associate Dean, College of Nursing & Health Sciences School of Nursing, The University of Texas at Tyler , Tyler , Texas , USA
| |
Collapse
|
29
|
A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program. Prev Med Rep 2018; 13:126-131. [PMID: 30568871 PMCID: PMC6299144 DOI: 10.1016/j.pmedr.2018.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/20/2018] [Accepted: 11/29/2018] [Indexed: 12/16/2022] Open
Abstract
The statewide Colorado Healthy Heart Solutions (CHHS) program provides cardiovascular disease (CVD) risk factor screening and education to the medically underserved and has been shown to improve CVD risk profiles. We aimed to enhance its effectiveness through addition of a mobile health (mHealth) intervention using SMS messaging (termed Cardio SMS). We conducted a prospective, non-randomized controlled pilot trial of this intervention implemented at 5 rural program sites (number of participants N = 204) compared with a contemporaneous propensity-score matched control group from 14 CHHS sites not receiving the intervention (N = 408) between 2012 and 2014. All participants were free of CVD at baseline, and follow-up time was 12-months. The primary outcome was program engagement, defined as the number of completed interactions with the program during the entire follow-up period. Secondary outcomes were program retention, defined as any interaction during the last two months of the study; change in self-reported healthy behaviors (physical activity, weight loss, smoking cessation, fat intake); and change in CVD risk factors. There were trends for differences between groups across multiple outcomes, but most did not reach statistical significance, except for a greater decrease in self-reported fat intake in the intervention vs. control groups (26.3% vs 10.6%, P = 0.001). In addition, a subset of surveyed participants who viewed the SMS messages as motivating showed greater program retention (P = 0.03). Given the relative ease and scalability of SMS interventions in rural underserved communities, further study of SMS as part of multicomponent strategies for CVD prevention is warranted.
Collapse
|
30
|
Patel A, Kuhite P, Puranik A, Khan SS, Borkar J, Dhande L. Effectiveness of weekly cell phone counselling calls and daily text messages to improve breastfeeding indicators. BMC Pediatr 2018; 18:337. [PMID: 30376823 PMCID: PMC6206669 DOI: 10.1186/s12887-018-1308-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 10/10/2018] [Indexed: 11/21/2022] Open
Abstract
Background Every year, nearly one million deaths occur due to suboptimal breastfeeding. If universally practiced, exclusive breastfeeding alone prevents 11.6% of all under 5 deaths. Among strategies to improve exclusive breastfeeding rates, counselling by peers or health workers, has proven to be highly successful. With growing availability of cell phones in India, they are fast becoming a medium to spread information for promoting healthcare among pregnant women and their families. This study was conducted to assess effectiveness of cell phones for personalized lactation consultation to improve breastfeeding practices. Methods This was a two arm, pilot study in four urban maternity hospitals, retrained in Baby Friendly Hospital Initiative. The enrolled mother-infant pairs resided in slums and received healthcare services at the study sites. The control received routine healthcare services, whereas, the intervention received weekly cell phone counselling and daily text messages, in addition to counselling the routine healthcare services. Results 1036 pregnant women were enrolled (518 - intervention and 518 - control). Rates of timely initiation of breastfeeding were significantly higher in intervention as compared to control (37% v/s 24%, p < 0.001). Pre-lacteal feeding rates were similar and low in both groups (intervention: 19%, control: 18%, p = 0.68). Rate of exclusive breastfeeding was similar between groups at 24 h after delivery, but significantly higher in the intervention at all subsequent visits (control vs. intervention: 24 h: 74% vs 74%, p = 1.0; 6 wk.: 81% vs 97%, 10 wk.: 78% vs 98%, 14 wk.: 71% vs 96%, 6 mo: 49% vs 97%, p < 0.001 for the last 4 visits). Adjusting for covariates, women in intervention were more likely to exclusively breastfeed than those in the control (AOR [95% CI]: 6.3 [4.9–8.0]). Conclusion Using cell phones to provide pre and postnatal breastfeeding counselling to women can substantially augment optimal practices. High rates of exclusive breastfeeding at 6 months were achieved by sustained contact and support using cell phones. This intervention shows immense potential for scale up by incorporation in both, public and private health systems. Trial registration This study was retrospectively registered with Clinical Trial Registry of India (http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=3060) Trial Number: CTRI/2011/06/001822 on date 20/06/2011.
Collapse
Affiliation(s)
- Archana Patel
- Department of Pediatrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra, 440018, India.,Lata Medical Research Foundation, Nagpur, Maharashtra, 440022, India
| | - Priyanka Kuhite
- Lata Medical Research Foundation, Nagpur, Maharashtra, 440022, India
| | - Amrita Puranik
- Lata Medical Research Foundation, Nagpur, Maharashtra, 440022, India.
| | | | - Jitesh Borkar
- Lata Medical Research Foundation, Nagpur, Maharashtra, 440022, India
| | - Leena Dhande
- Department of Pediatrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra, 440018, India
| |
Collapse
|
31
|
Ludwig K, Arthur R, Sculthorpe N, Fountain H, Buchan DS. Text Messaging Interventions for Improvement in Physical Activity and Sedentary Behavior in Youth: Systematic Review. JMIR Mhealth Uhealth 2018; 6:e10799. [PMID: 30224335 PMCID: PMC6231724 DOI: 10.2196/10799] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/13/2018] [Accepted: 06/16/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The use of text messages (short message service, SMS) to change physical activity and sedentary behavior in youth is of interest due to the need for novel, more effective intervention approaches. Previous reviews have examined a variety of technology-based interventions and their impact on different health behaviors, but evidence regarding the impact of just SMS on physical activity and sedentary behavior is lacking. OBJECTIVE The aim of this study was to assess the effectiveness and use of theory of SMS interventions for improving physical activity and sedentary behavior in youth. METHODS Authors systematically searched electronic databases from March to November 2017. Citations were sifted using additional reviewers, and a qualitative synthesis of eligible studies was conducted using piloted data extraction forms. To be eligible for inclusion, studies had to be of a randomized controlled or quasi-experimental design, incorporate SMS, involve adolescents between the ages of 10 and 19 years, and assess at least one physical activity or sedentary behavior outcome. Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. RESULTS A total of 13 studies reporting 11 interventions were included in the qualitative analysis. Studies included interventions that were conducted in schools, online, or face-to-face. Studies were of high heterogeneity with regard to study duration, participant characteristics, intervention content, and outcome measures. Findings were equivocal with regard to intervention effectiveness for physical activity and sedentary behavior. Overall, 7 interventions resulted in an improvement for physical activity and 6 for sedentary behavior. All studies were judged to be of high risk of bias for at least 1 item. CONCLUSIONS Some studies in this review showed promising results for using SMS to improve physical activity and sedentary behavior in youth. High heterogeneity of design and outcome measures precluded data pooling and conclusions as to which specific intervention elements are linked to increased effectiveness cannot be drawn. The authors propose incorporating the following elements in future studies: specific focus on desired health behavior; mixed-methods design; include long-term follow-up; include self-monitoring, goal setting, and feedback; combine SMS with a mobile app; and send 3 or more SMS text messages per week. More rigorous studies are needed to explore the relationship between intervention effectiveness and specific intervention components such as content and delivery.
Collapse
Affiliation(s)
- Kim Ludwig
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Blantyre, United Kingdom
| | - Rosie Arthur
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Blantyre, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Blantyre, United Kingdom
| | - Hollie Fountain
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Duncan S Buchan
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Blantyre, United Kingdom
| |
Collapse
|
32
|
Alvarez-Tobón VA, Luna-Gómez IF, Torres-Silva EA, Higuita-Úsuga A, Rivera-Mejía PT. Tecnologías de Información y Comunicación (TIC) aplicadas en cuidados paliativos: revisión de tema. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objetivo: Revisar las herramientas utilizadas en las investigaciones de e-salud en cuidados paliativos durante los últimos cinco años Método: se realizó una revisión bibliográfica en las bases de datos PubMed, Scopus y Bireme sobre el tema de cuidados paliativos, e-salud y costos en los últimos cinco años. Resultados: El uso de las tecnologías de la información es favorable para usuarios que reciben cuidados paliativos, ya que facilita su seguimiento y el manejo de sus síntomas, además de mejorar la comunicación entre profesionales y pacientes, disminuyendo en algunos casos los desplazamientos geográficos y reduciendo los costos asociados a la atención de estos pacientes. Conclusión: la e-salud implementada a través de diferentes herramientas de intervención ha demostrado ser valiosa para los pacientes con enfermedad avanzada en cuidados paliativos, ofreciendo potenciales beneficios educativos y de optimización de recursos y tiempo para pacientes, cuidadores, que les permite mejorar su contacto con profesionales de la salud.
Collapse
|
33
|
Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening. J Clin Med 2018; 7:jcm7080181. [PMID: 30042291 PMCID: PMC6111615 DOI: 10.3390/jcm7080181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.
Collapse
|
34
|
Campbell AR, Kinvig K, Côté HC, Lester RT, Qiu AQ, Maan EJ, Alimenti A, Pick N, Murray MC. Health Care Provider Utilization and Cost of an mHealth Intervention in Vulnerable People Living With HIV in Vancouver, Canada: Prospective Study. JMIR Mhealth Uhealth 2018; 6:e152. [PMID: 29986845 PMCID: PMC6056738 DOI: 10.2196/mhealth.9493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/25/2018] [Accepted: 06/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background Improving adherence to combined antiretroviral therapy (cART) can be challenging, especially among vulnerable populations living with HIV. Even where cART is available free of charge, social determinants of health act as barriers to optimal adherence rates. Patient-centered approaches exploiting mobile phone communications (mHealth) have been shown to improve adherence to cART and promote achievement of suppressed HIV plasma viral loads. However, data are scarce on the health care provider (HCP) time commitments and health care costs associated with such interventions. This knowledge is needed to inform policy and programmatic implementation. Objective The purpose of this study was to approximate the resources required and to provide an estimate of the costs associated with running an mHealth intervention program to improve medication adherence in people living with HIV (PLWH). Methods This prospective study of HCP utilization and costs was embedded within a repeated measures effectiveness study of the WelTel short-message service (SMS) mHealth program. The study included 85 vulnerable, nonadherent PLWH in Vancouver, Canada, and resulted in improved medication adherence and HIV plasma viral load among participants. Study participants were provided mobile phones with unlimited texting (where required) and received weekly bidirectional text messages to inquire on their status for one year. A clinic nurse triaged and managed participants' responses, immediately logging all patient interactions by topic, HCP involvement, and time dedicated to addressing issues raised by participants. Interaction costs were determined in Canadian dollars based on HCP type, median salary within our health authority, and their time utilized as part of the intervention. Results Participant-identified problems within text responses included health-related, social, and logistical issues. Taken together, management of problems required a median of 43 minutes (interquartile range, IQR 17-99) of HCP time per participant per year, for a median yearly cost of Can $36.72 (IQR 15.50-81.60) per participant who responded with at least one problem. The clinic nurse who monitored the texts solved or managed 65% of these issues, and the remaining were referred to a variety of other HCPs. The total intervention costs, including mobile phones, plans, and staffing were a median Can $347.74/highly vulnerable participant per year for all participants or Can $383.18/highly vulnerable participant per year for those who responded with at least one problem. Conclusions Bidirectional mHealth programs improve HIV care and treatment outcomes for PLWH. Knowledge about the HCP cost associated, here less than Can $50/year, provides stakeholders and decision makers with information relevant to determining the feasibility and sustainability of mHealth programs in a real-world setting. Trial Registration ClinicalTrials.gov NCT02603536; https://clinicaltrials.gov/ct2/show/NCT02603536 (Archived by WebCite at http://www.webcitation.org/70IYqKUjV).
Collapse
Affiliation(s)
- Amber R Campbell
- Division of Experimental Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada.,Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Karen Kinvig
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Hélène Cf Côté
- Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - Richard T Lester
- Division of Infectious Disease, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Annie Q Qiu
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Evelyn J Maan
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada.,Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Ariane Alimenti
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Neora Pick
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada.,Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada.,Division of Infectious Disease, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Melanie Cm Murray
- Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada.,Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada.,Division of Infectious Disease, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
35
|
Crombie IK, Irvine L, Williams B, Sniehotta FF, Petrie DJ, Jones C, Norrie J, Evans JMM, Emslie C, Rice PM, Slane PW, Humphris G, Ricketts IW, Melson AJ, Donnan PT, McKenzie A, Huang L, Achison M. Text message intervention to reduce frequency of binge drinking among disadvantaged men: the TRAM RCT. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Socially disadvantaged men are more likely to binge drink frequently and to experience high levels of alcohol-related harm.
Objectives
To test the effectiveness and cost-effectiveness of a text message intervention in reducing the frequency of binge drinking among disadvantaged men.
Study design
A four-centre, parallel-group, pragmatic, individually randomised controlled trial was conducted. Randomisation was carried out using a secure remote web-based system. It was stratified by participating centre and recruitment method and restricted using block sizes of randomly varying lengths.
Setting
The study was conducted in the community. Members of the public helped to develop the study methods.
Participants
Participants were men aged 25–44 years who had ≥ 2 episodes of binge drinking (> 8 units of alcohol in a single session) in the preceding 28 days. Men were recruited from areas of high deprivation.
Interventions
An empirically and theoretically based text message intervention was delivered by 112 interactive text messages over a 12-week period. The control group received an attentional control comprising 89 text messages on general health.
Primary outcome measure
The primary outcome measure was the proportion of men consuming > 8 units of alcohol on ≥ 3 occasions (in the previous 28 days) at 12 months post intervention.
Results
The recruitment target of 798 was exceeded and 825 men were randomised. Retention was high and similar in the intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged enthusiastically with the text messages: almost all (92%) replied to text messages and over two-thirds (67%) replied more than 10 times. The intervention was estimated to have had a modest, statistically non-significant effect on the primary outcome at the 12-month follow-up [odds ratio 0.79, 95% confidence interval (CI) 0.57 to 1.08]. This corresponds to a net reduction of 5.7% in regular binge drinking. Five secondary outcomes showed small non-significant and inconsistent effects on alcohol consumption, with one suggesting a positive effect and four suggesting an adverse effect. Both the short- and the long-term cost per quality-adjusted life-year (QALY) analysis suggested that the brief intervention was dominated by a ‘do-nothing’ option. The intervention’s impacts on patterns of alcohol consumption, QALYs and downstream costs were inconsistent and uncertain.
Limitations
The study used an active control that, combined with the recruitment procedures and baseline assessments, could have biased the treatment effect towards the null. The measurement of alcohol consumption relied on self-reported drinking.
Conclusions
The trial has demonstrated that it is possible to recruit and retain large numbers of socially disadvantaged men in a research study. The text messages delivered a complex theoretically and empirically based intervention that fostered enthusiastic engagement with the key components of the behaviour change sequence. The intervention produced a modest, statistically non-significant effect on the primary outcome, with wide CIs. Further research is needed to reduce uncertainty about the treatment effect. The methods developed for this study provide a platform for the design and testing of interventions to reduce inequalities in health.
Future work
A future trial could reduce the uncertainty around the treatment effect of the intervention.
Trial registration
Current Controlled Trials ISRCTN07695192.
Funding
This study was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 6. See NIHR Journals Library website for further information.
Collapse
Affiliation(s)
- Iain K Crombie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Linda Irvine
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Dennis J Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Josie MM Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Carol Emslie
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Peter M Rice
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Peter W Slane
- Erskine Practice, Arthurstone Medical Centre, Dundee, UK
| | - Gerry Humphris
- School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, UK
| | | | - Ambrose J Melson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Peter T Donnan
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Andrew McKenzie
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| | - Li Huang
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marcus Achison
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK
| |
Collapse
|
36
|
Slater H, Briggs A, Stinson J, Campbell JM. End user and implementer experiences of mHealth technologies for noncommunicable chronic disease management in young adults: a qualitative systematic review protocol. ACTA ACUST UNITED AC 2018; 15:2047-2054. [PMID: 28800054 DOI: 10.11124/jbisrir-2016-003299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
REVIEW OBJECTIVE The objective of this review is to systematically identify, review and synthesize relevant qualitative research on end user and implementer experiences of mobile health (mHealth) technologies developed for noncommunicable chronic disease management in young adults. "End users" are defined as young people aged 15-24 years, and "implementers" are defined as health service providers, clinicians, policy makers and administrators.The two key questions we wish to systematically explore from identified relevant qualitative studies or studies with qualitative components are.
Collapse
Affiliation(s)
- Helen Slater
- 1School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia 2Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada 3Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada 4Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | |
Collapse
|
37
|
Goldstein SP, Evans BC, Flack D, Juarascio A, Manasse S, Zhang F, Forman EM. Return of the JITAI: Applying a Just-in-Time Adaptive Intervention Framework to the Development of m-Health Solutions for Addictive Behaviors. Int J Behav Med 2018; 24:673-682. [PMID: 28083725 DOI: 10.1007/s12529-016-9627-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Lapses are strong indicators of later relapse among individuals with addictive disorders, and thus are an important intervention target. However, lapse behavior has proven resistant to change due to the complex interplay of lapse triggers that are present in everyday life. It could be possible to prevent lapses before they occur by using m-Health solutions to deliver interventions in real-time. METHOD Just-in-time adaptive intervention (JITAI) is an intervention design framework that could be delivered via mobile app to facilitate in-the-moment monitoring of triggers for lapsing, and deliver personalized coping strategies to the user to prevent lapses from occurring. An organized framework is key for successful development of a JITAI. RESULTS Nahum-Shani and colleagues (2014) set forth six core elements of a JITAI and guidelines for designing each: distal outcomes, proximal outcomes, tailoring variables, decision points, decision rules, and intervention options. The primary aim of this paper is to illustrate the use of this framework as it pertains to developing a JITAI that targets lapse behavior among individuals following a weight control diet. CONCLUSION We will detail our approach to various decision points during the development phases, report on preliminary findings where applicable, identify problems that arose during development, and provide recommendations for researchers who are currently undertaking their own JITAI development efforts. Issues such as missing data, the rarity of lapses, advantages/disadvantages of machine learning, and user engagement are discussed.
Collapse
Affiliation(s)
- Stephanie P Goldstein
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA.
| | - Brittney C Evans
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Daniel Flack
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Adrienne Juarascio
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Stephanie Manasse
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Fengqing Zhang
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| | - Evan M Forman
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA, 19104, USA
| |
Collapse
|
38
|
Criss S, Blaine RE, Palamé M, Perkins M, Davison K, Kwass JA, Taveras EM. Health Marketing for the Massachusetts Childhood Obesity Research Demonstration Study: A Case Study. Health Promot Pract 2018; 20:282-291. [PMID: 29566576 DOI: 10.1177/1524839918760842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. This case study describes the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD) health marketing campaign, examines the strategies used in such campaigns, and offers lessons learned to improve health marketing for future interventions. MA-CORD Health Marketing Components and Implementation. The three main components were an outdoor printed advertisement and texting campaign, social media with a focus on Facebook, and the Summer Passport Program, an event-based initiative in parks for children. The advertisements consisted of billboards, bus advertisements, and handouts. The text messaging component, which required families to actively text a keyword to join, had a low opt-in rate. Facebook page "likes" increased from 1,024 to 1,453 in New Bedford and from 175 to 1,091 in Fitchburg. Fitchburg received technical assistance and paid for ads on Facebook. The Summer Passport participation in parks ranged from 120 to 875 children with participation in the free park lunch program doubling in Fitchburg. Discussion. Key lessons learned are engage communication experts from each community at the beginning of the project, use text messaging components with in-person staff onsite to assist participants in the opt-in process, build momentum for a Facebook presence through purchasing Facebook advertisements, and partner with local park departments for programming.
Collapse
Affiliation(s)
| | | | | | | | | | - Jo-Ann Kwass
- Massachusetts Department of Public Health, Boston, MA, USA
| | | | | |
Collapse
|
39
|
DeMartini KS, Schilsky ML, Palmer A, Fehon DC, Zimbrean P, O'Malley SS, Lee HB, Toll BA. Text Messaging to Reduce Alcohol Relapse in Prelisting Liver Transplant Candidates: A Pilot Feasibility Study. Alcohol Clin Exp Res 2018; 42:761-769. [PMID: 29498753 DOI: 10.1111/acer.13603] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 01/22/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Many liver transplantation programs require documented alcohol sobriety prior to United Network for Organ Sharing (UNOS) listing. This pilot study examined the feasibility of the first mobile, alcohol relapse prevention intervention for liver transplant patients with alcoholic liver disease (ALD). METHODS This was a randomized 8-week pilot feasibility trial of a text message-based alcohol intervention. In-treatment assessment was conducted at 4 weeks (4W), and immediate posttreatment assessment was conducted at 8W. Participants were liver transplant candidates (N = 15) diagnosed with ALD who reported at least 1 drinking episode in the past year. Primary feasibility outcomes were percent of messages responded to and posttreatment intervention satisfaction ratings. Preliminary clinical efficacy outcomes were any biologically confirmed alcohol consumption, stress, abstinence self-efficacy, and alcohol craving. RESULTS On feasibility outcomes, participants responded to 81% of messages received and reported high rates of intervention satisfaction, looked forward to receiving the messages, and found it easy to complete the intervention. On preliminary efficacy outcomes, zero participants in the text message (TM) had positive urine alcohol tests at 8W. Two of the 6 participants in standard care (SC) tested positive at 8W. No effects were seen on craving. For stress, a condition × time interaction emerged. TM participants had less stress at 4W and 8W compared with SC at baseline. They maintained their stress level during the intervention. For self-efficacy, a trend for condition effect emerged. TM participants had higher self-efficacy than SC participants. CONCLUSIONS Participants reported high satisfaction with the intervention, looked forward to the messages, and found it easy to complete. Participants who received the intervention had better treatment outcomes than those who received standard care. They maintained higher levels of self-efficacy and lower stress. Mobile alcohol interventions may hold significant promise to help ALD liver transplant patients maintain sobriety.
Collapse
Affiliation(s)
- Kelly S DeMartini
- Department of Psychiatry, Smilow Cancer Hospital at Yale, Yale School of Medicine, New Haven, Connecticut
| | - Michael L Schilsky
- Departments of Medicine and Surgery, Divisions of Digestive Diseases and Transplantation and Immunology, Yale-New Transplantation Center, Yale School of Medicine, New Haven, Connecticut
| | - Amanda Palmer
- Moffitt Cancer Center, University of South Florida, Tampa, Florida
| | - Dwain C Fehon
- Liver Transplantation Center, Yale-New Haven Hospital, New Haven, Connecticut
| | - Paula Zimbrean
- Liver Transplantation Center, Yale-New Haven Hospital, New Haven, Connecticut
| | | | - Hochang B Lee
- Department of Psychological Medicine, Yale-New Haven Hospital, New Haven, Connecticut
| | - Benjamin A Toll
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
40
|
Hébert ET, Stevens EM, Frank SG, Kendzor DE, Wetter DW, Zvolensky MJ, Buckner JD, Businelle MS. An ecological momentary intervention for smoking cessation: The associations of just-in-time, tailored messages with lapse risk factors. Addict Behav 2018; 78:30-35. [PMID: 29121530 DOI: 10.1016/j.addbeh.2017.10.026] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/16/2017] [Accepted: 10/27/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Smartphone apps can provide real-time, tailored interventions for smoking cessation. The current study examines the effectiveness of a smartphone-based smoking cessation application that assessed risk for imminent smoking lapse multiple times per day and provided messages tailored to current smoking lapse risk and specific lapse triggers. METHODS Participants (N=59) recruited from a safety-net hospital smoking cessation clinic completed phone-based ecological momentary assessments (EMAs) 5 times/day for 3 consecutive weeks (1week pre-quit, 2weeks post-quit). Risk for smoking lapse was estimated in real-time using a novel weighted lapse risk estimator. With each EMA, participants received messages tailored to current level of risk for imminent smoking lapse and self-reported presence of smoking urge, stress, cigarette availability, and motivation to quit. Generalized linear mixed model analyses determined whether messages tailored to specific lapse risk factors were associated with greater reductions in these triggers than messages not tailored to specific triggers. RESULTS Overall, messages tailored to smoking urge, cigarette availability, or stress corresponded with greater reductions in those triggers than messages that were not tailored to specific triggers (p's=0.02 to <0.001). Although messages tailored to stress were associated with greater reductions in stress than messages not tailored to stress, the association was non-significant (p=0.892) when only moments of high stress were included in the analysis. CONCLUSIONS Mobile technology can be used to conduct real-time smoking lapse risk assessment and provide tailored treatment content. Findings provide initial evidence that tailored content may impact users' urge to smoke, stress, and cigarette availability.
Collapse
Affiliation(s)
- Emily T Hébert
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
| | - Elise M Stevens
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Summer G Frank
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Darla E Kendzor
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - David W Wetter
- Department of Population Health Sciences and the Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Michael J Zvolensky
- The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, Houston, TX, United States
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Michael S Businelle
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
41
|
Domek GJ, Contreras-Roldan IL, Asturias EJ, Bronsert M, Bolaños Ventura GA, O’Leary ST, Kempe A, Bull S. Characteristics of mobile phone access and usage in rural and urban Guatemala: assessing feasibility of text message reminders to increase childhood immunizations. Mhealth 2018; 4:9. [PMID: 29780812 PMCID: PMC5945665 DOI: 10.21037/mhealth.2018.03.05] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/21/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Despite efforts to promote vaccination in low- and middle-income countries (LMICs), over 20 million infants remain under-immunized and at risk for unnecessary morbidity and mortality. Mobile health technologies, such as Short Message Service (SMS) texts, have tremendous and untapped potential for disease management. Patient reminder systems are an important mechanism for improving childhood vaccination coverage and can be easily adapted to SMS platforms. However, current research lacks an understanding of the barriers and facilitators to mHealth program design, implementation, and scale in LMICs. METHODS We analyzed survey data collected March-November 2016 at the enrollment visit from a randomized controlled trial conducted at public health clinics in urban and rural Guatemala. Participants included eligible infants 6 weeks to 6 months of age receiving the first dose of the primary immunization series. At least one parent needed to own a mobile phone and be capable of deciphering SMS. Chi-square or Fisher's exact and Student's t-test were used to assess significance levels in demographic differences to describe factors that contribute to the feasibility of using an SMS-based vaccination reminder system. RESULTS Of 1,088 families approached for enrollment, 871 were eligible and 720 (82.7%) participated with equal numbers of urban and rural children enrolled; 54 parents did not own a mobile phone with SMS capability and three parents could not use SMS. There was no significant difference between urban and rural maternal mobile phone ownership (94.4% vs. 93.3%, P=0.53), but more urban fathers owned mobile phones (72.8% vs. 47.1%, P<0.0001) and, overall, more mothers compared to fathers owned mobile phones (93.9% vs. 61.1%, P<0.0001). Most families (90.4%) chose to have reminders sent to the mother. Urban participants reported more mobile phones present in the home (P<0.0001), but rural participants reported more telephone landlines (34.7% vs. 15.6%, P<0.0001). Most participants reported a daily average of ≤5 telephone calls made (87.4%), ≤10 texts sent (91.0%), and ≤10 texts received (89.9%), with urban families reporting greater telephone usage (P=0.006, P<0.001, and P<0.001 respectively). Parents preferred to make calls over sending texts (74.7% vs. 25.3%, P<0.0001), with more urban families preferring text messaging (31.9% vs. 18.6%, P<0.0001). CONCLUSIONS Our study results provide important insight into mobile phone access, usage, and preferences for voice and text communication across rural and urban populations of an LMIC that can be used to inform future mHealth interventions. Our findings suggest that offering a combination of more traditional communication methods with newer, modern technologies may be more effective at reminding families about vaccination visits, particularly for our rural population, and that targeting mothers for mobile phone interventions may provide the greatest benefits. Overall, our study suggests that using SMS reminders in LMICs can be a feasible tool for public health interventions.
Collapse
Affiliation(s)
- Gretchen J. Domek
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Center for Global Health, Colorado School of Public Health; Mail Stop A090, 13199 E Montview Blvd., Suite 310, Aurora, CO 80045, USA
| | | | - Edwin J. Asturias
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Center for Global Health, Colorado School of Public Health; Mail Stop A090, 13199 E Montview Blvd., Suite 310, Aurora, CO 80045, USA
| | - Michael Bronsert
- Center for Global Health, Colorado School of Public Health; Mail Stop A090, 13199 E Montview Blvd., Suite 310, Aurora, CO 80045, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Sean T. O’Leary
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Allison Kempe
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Sheana Bull
- Center for Global Health, Colorado School of Public Health; Mail Stop A090, 13199 E Montview Blvd., Suite 310, Aurora, CO 80045, USA
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO 80045, USA
| |
Collapse
|
42
|
McCarroll R, Eyles H, Ni Mhurchu C. Effectiveness of mobile health (mHealth) interventions for promoting healthy eating in adults: A systematic review. Prev Med 2017; 105:156-168. [PMID: 28882743 DOI: 10.1016/j.ypmed.2017.08.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 08/16/2017] [Accepted: 08/27/2017] [Indexed: 01/11/2023]
Abstract
Unhealthy eating is a major risk factor for chronic disease. However, many current strategies to promote healthy eating are not sustainable over the longer-term. More cost-effective wide-reaching initiatives are urgently needed. Mobile health (mHealth) interventions, delivered via mobile devices, could provide a solution. This systematic review summarized the evidence on the effect of mHealth interventions for promoting healthy eating in adults. A comprehensive systematic search of five scientific databases was conducted using methods adapted from the Cochrane Handbook. Eligible studies were randomized controlled trials (RCTs), published up to 1 July 2016, which examined healthy eating interventions delivered via mobile device. Of 879 articles identified, 84 full text articles were potentially eligible and further assessed, and 23 included. Narrative review results indicated small positive effects of mHealth interventions on healthy eating (5/8 trials) and weight loss (5/13 trials). However, the current evidence base is insufficient (studies are of poor quality) to determine conclusive positive effects. More rigorous RCTs with longer-term (>6months) follow-up are warranted to determine if effects are maintained.
Collapse
Affiliation(s)
- Rebecca McCarroll
- National Institute for Health Innovation, University of Auckland, PO Box 92019, Auckland, New Zealand.
| | - Helen Eyles
- National Institute for Health Innovation, University of Auckland, PO Box 92019, Auckland, New Zealand; Epidemiology and Biostatistics, University of Auckland, PO Box 92019, Auckland, New Zealand.
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, PO Box 92019, Auckland, New Zealand.
| |
Collapse
|
43
|
Roth AM, Felsher M, Reed M, Goldshear JL, Truong Q, Garfein RS, Simmons J. Potential benefits of using ecological momentary assessment to study high-risk polydrug use. Mhealth 2017; 3:46. [PMID: 29184898 PMCID: PMC5682359 DOI: 10.21037/mhealth.2017.10.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/30/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND While studies have documented both the feasibility and acceptability of using ecological momentary assessment (EMA) to study drug use, there is little empirical research assessing participants' perceptions of utilizing this technology-driven approach. METHODS Participants were English-speaking persons ≥18 years old who reported injection drug use and sequential (e.g., alcohol followed by opioid use) or simultaneous (i.e., injecting heroin and cocaine in one shot) polydrug use within 30 days recruited in San Diego, CA and Philadelphia, PA. Participants (N=36) completed two cell phone-based EMA simulations assessing mood, drug use, HIV risk behaviors, and daily activities, followed by semi-structured interviews that probed for potential benefits of participation over time. Qualitative analysis involved an iterative process of reviewing texts from the interviews to create a coding framework, which was then applied to all transcripts to identify themes. RESULTS Findings suggest participants may derive indirect benefits from participation in EMA studies including: improved self-worth from helping others; experiencing increased social support through utilization of the study-provided mobile device for non-research purposes; and most importantly, increased self-reflection, which could lead to therapeutic and intervention-like effects such as decreased substance use or reduced HIV risk. CONCLUSIONS Participants identified a variety of potential benefits from participating in a study that utilizes EMA. This research suggests that benefits are highly salient for individuals involved in studies of polydrug use.
Collapse
Affiliation(s)
- Alexis M. Roth
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Marisa Felsher
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Megan Reed
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Jesse L. Goldshear
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, USA
| | - Quan Truong
- Palo Alto Medical Foundation Research Institute, Mountain View, CA, USA
| | - Richard S. Garfein
- Department of Medicine, Division of Global Public Health, University of California, San Diego, USA
| | - Janie Simmons
- National Development and Research Institutes, Inc., New York, USA
| |
Collapse
|
44
|
Matthews L, Pugmire J, Moore L, Kelson M, McConnachie A, McIntosh E, Morgan-Trimmer S, Murphy S, Hughes K, Coulman E, Utkina-Macaskill O, Simpson SA. Study protocol for the 'HelpMeDoIt!' randomised controlled feasibility trial: an app, web and social support-based weight loss intervention for adults with obesity. BMJ Open 2017; 7:e017159. [PMID: 29074513 PMCID: PMC5665248 DOI: 10.1136/bmjopen-2017-017159] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/30/2017] [Accepted: 08/04/2017] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION HelpMeDoIt! will test the feasibility of an innovative weight loss intervention using a smartphone app and website. Goal setting, self-monitoring and social support are three key facilitators of behaviour change. HelpMeDoIt! incorporates these features and encourages participants to invite 'helpers' from their social circle to help them achieve their goal(s). AIM To test the feasibility of the intervention in supporting adults with obesity to achieve weight loss goals. METHODS AND ANALYSIS 12-month feasibility randomised controlled trial and accompanying process evaluation. Participants (n=120) will be adults interested in losing weight, body mass index (BMI)> 30 kg/m2 and smartphone users. The intervention group will use the app/website for 12 months. Participants will nominate one or more helpers to support them. Helpers have access to the app/website. The control group will receive a leaflet on healthy lifestyle and will have access to HelpMeDoIt! after follow-up. The key outcome of the study is whether prespecified progression criteria have been met in order to progress to a larger randomised controlled effectiveness trial. Data will be collected at baseline, 6 and 12 months. Outcomes focus on exploring the feasibility of delivering the intervention and include: (i) assessing three primary outcomes (BMI, physical activity and diet); (ii) secondary outcomes of waist/hip circumference, health-related quality of life, social support, self-efficacy, motivation and mental health; (iii) recruitment and retention; (iv) National Health Service (NHS) resource use and participant borne costs; (v) usability and acceptability of the app/website; and (vi) qualitative interviews with up to 50 participants and 20 helpers on their experiences of the intervention. Statistical analyses will focus on feasibility outcomes and provide initial estimates of intervention effects. Thematic analysis of qualitative interviews will assess implementation, acceptability, mechanisms of effect and contextual factors influencing the intervention. ETHICS AND DISSEMINATION The protocol has been approved by the West of Scotland NHS Research Ethics Committee (Ref: 15/WS/0288) and the University of Glasgow MVLS College Ethics Committee (Ref: 200140108). Findings will be disseminated widely through peer-reviewed publication and conference presentations. TRIAL REGISTRATION NUMBER ISRCTN85615983.
Collapse
Affiliation(s)
- Lynsay Matthews
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Juliana Pugmire
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Kelson
- College of Engineering, Mathematics, and Physical Sciences, Data Science Institute, University of Exeter, Exeter, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment Unit (HEHTA), Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sarah Morgan-Trimmer
- Psychology Applied to Health (PAtH) Group, Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Simon Murphy
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff School of Social Sciences, Cardiff, UK
| | - Kathryn Hughes
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Elinor Coulman
- Centre for Trials Research (CTR), School of Medicine, Cardiff University, Cardiff, UK
| | - Olga Utkina-Macaskill
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sharon Anne Simpson
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
45
|
Abstract
UWALK is a multi-strategy, multi-sector, theory-informed, community-wide approach using e and mHealth to promote physical activity in Alberta, Canada. The aim of UWALK is to promote physical activity, primarily via the accumulation of steps and flights of stairs, through a single over-arching brand. This paper describes the development of the UWALK program. A social ecological model and the social cognitive theory guided the development of key strategies, including the marketing and communication activities, establishing partnerships with key stakeholders, and e and mHealth programs. The program promotes the use of physical activity monitoring devices to self-monitor physical activity. This includes pedometers, electronic devices, and smartphone applications. In addition to entering physical activity data manually, the e and mHealth program provides the function for objective data to be automatically uploaded from select electronic devices (Fitbit®, Garmin and the smartphone application Moves) The RE-AIM framework is used to guide the evaluation of UWALK. Funding for the program commenced in February 2013. The UWALK brand was introduced on April 12, 2013 with the official launch, including the UWALK website on September 20, 2013. This paper describes the development and evaluation framework of a physical activity promotion program. This program has the potential for population level dissemination and uptake of an ecologically valid physical activity promotion program that is evidence-based and theoretically framed.
Collapse
|
46
|
Kreyenbuhl J, Record EJ, Palmer-Bacon J. A review of behavioral tailoring strategies for improving medication adherence in serious mental illness. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27489459 PMCID: PMC4969706 DOI: 10.31887/dcns.2016.18.2/jkreyenbuhl] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nonadherence to psychopharmacological treatments poses a significant challenge to treatment success in individuals with serious mental illness, with upwards of 60% of people not taking their psychiatric medications as prescribed. Nonadherence is associated with adverse outcomes, including exacerbation of psychiatric symptoms, impaired functioning, increased hospitalizations and emergency room use, and increased health care costs. Whereas interventions using psychoeducation or cognitive approaches, such as motivational interviewing, have largely proven ineffective in improving adherence, approaches employing behavioral tailoring that incorporate medication taking into the daily routine and/or use environmental supports have shown promise. Recently, adherence-enhancing behavioral tailoring interventions that utilize novel technologies, such as electronic monitors and mobile phones, have been developed. Although interventions utilizing these platforms have the potential for widespread dissemination to a broad range of individuals, most require further empirical testing. This paper reviews selected behavioral tailoring strategies that aim to improve medication adherence and other functional outcomes among individuals with serious mental illness.
Collapse
Affiliation(s)
- Julie Kreyenbuhl
- University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, Maryland, USA ; VA Capitol Healthcare Network (VISN 5) Mental lllness Research, Education, and Clinical Center (MIRECC), Baltimore, Maryland, USA
| | | | - Jessica Palmer-Bacon
- University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, Maryland, USA; University of Maryland School of edicine, Baltimore, Maryland, USA
| |
Collapse
|
47
|
Som A, Patel K, Sink E, Peters RM, Javaherian K, Groenendyk J, An T, Xu Z, Polites GM, Blanchard M, Ross W. A Novel Patient Engagement Platform Using Accessible Text Messages and Calls (Epharmix): Feasibility Study. JMIR Form Res 2017; 1:e2. [PMID: 30684401 PMCID: PMC6334683 DOI: 10.2196/formative.7211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/17/2017] [Accepted: 07/21/2017] [Indexed: 11/25/2022] Open
Abstract
Background Patient noncompliance with therapy, treatments, and appointments represents a significant barrier to improving health care delivery and reducing the cost of care. One method to improve therapeutic adherence is to improve feedback loops in getting clinically acute events and issues to the relevant clinical providers as necessary (ranging from detecting hypoglycemic events for patients with diabetes to notifying the provider when patients are out of medications). Patients often don’t know which information should prompt a call to their physician and proactive checks by the clinics themselves can be very resource intensive. We hypothesized that a two-way SMS system combined with a platform web service for providers would enable both high patient engagement but also the ability to detect relevant clinical alerts. Objective The objectives of this study are to develop a feasible two-way automated SMS/phone call + web service platform for patient-provider communication, and then study the feasibility and acceptability of the Epharmix platform. First, we report utilization rates over the course of the first 18 months of operation including total identified clinically significant events, and second, review results of patient user-satisfaction surveys for interventions for patients with diabetes, COPD, congestive heart failure, hypertension, surgical site infections, and breastfeeding difficulties. Methods To test this question, we developed a web service + SMS/phone infrastructure (“Epharmix”). Utilization results were measured based on the total number of text messages or calls sent and received, with percentage engagement defined as a patient responding to a text message at least once in a given week, including the number of clinically significant alerts generated. User satisfaction surveys were sent once per month over the 18 months to measure satisfaction with the system, frequency and degree of communication. Descriptive statistics were used to describe the above information. Results In total, 28,386 text messages and 24,017 calls were sent to 929 patients over 9 months. Patients responded to 80% to 90% of messages allowing the system to detect 1164 clinically significant events. Patients reported increased satisfaction and communication with their provider. Epharmix increased the number of patient-provider interactions to over 10 on average in any given month for patients with diabetes, COPD, congestive heart failure, hypertension, surgical site infections, and breastfeeding difficulties. Conclusions Engaging high-risk patients remains a difficult process that may be improved through novel, digital health interventions. The Epharmix platform enables increased patient engagement with very low risk to improve clinical outcomes. We demonstrated that engagement among high-risk populations is possible when health care comes conveniently to where they are.
Collapse
Affiliation(s)
- Avik Som
- Washington University School of Medicine, St. Louis, MO, United States
| | - Kunjan Patel
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Eric Sink
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | | | - Kavon Javaherian
- Washington University School of Medicine, St. Louis, MO, United States
| | - Jacob Groenendyk
- Washington University School of Medicine, St. Louis, MO, United States
| | - Tonya An
- Washington University School of Medicine, St. Louis, MO, United States
| | - Zhuchen Xu
- Washington University School of Medicine, St. Louis, MO, United States
| | - Gregory M Polites
- Washington University School of Medicine, St. Louis, MO, United States
| | - Melvin Blanchard
- Washington University School of Medicine, St. Louis, MO, United States
| | - Will Ross
- Department of Internal Medicine, Renal Division, Washington University School of Medicine, St. Louis, MO, United States
| |
Collapse
|
48
|
Harvey J, Dittus K, Mench E. eHealth and behavioral weight loss interventions for female cancer survivors: A review. ACTA ACUST UNITED AC 2017; 13:80-88. [PMID: 28905688 PMCID: PMC7789030 DOI: 10.1177/1745505717731012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cancer survivors are at increased risk of chronic disease and diminished quality
of life. The presence of overweight and obesity can exacerbate these health
risks. Fortunately, even small weight losses have been found to produce
clinically meaningful health outcomes. However, effective obesity treatment is
difficult to access, and recently, efforts have been made to disseminate
interventions using eHealth or distantly delivered technology. This review aims
to focus on the efficacy and limitations of these technologies for female cancer
survivors. Suggestions are also provided to encourage further meaningful work in
this area.
Collapse
Affiliation(s)
- Jean Harvey
- 1 Department of Nutrition and Food Sciences, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Kim Dittus
- 2 Department of Internal Medicine, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Elise Mench
- 3 Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, USA
| |
Collapse
|
49
|
Dario AB, Moreti Cabral A, Almeida L, Ferreira ML, Refshauge K, Simic M, Pappas E, Ferreira PH. Effectiveness of telehealth-based interventions in the management of non-specific low back pain: a systematic review with meta-analysis. Spine J 2017; 17:1342-1351. [PMID: 28412562 DOI: 10.1016/j.spinee.2017.04.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 03/12/2017] [Accepted: 04/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP); however, its effectiveness has not been investigated. PURPOSE The aim of this review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP. STUDY DESIGN This is a systematic review with meta-analysis. METHODS Seven databases were searched from the earliest records to August 2015. Eligible studies were randomized controlled trials that investigated the effectiveness of telehealth-based interventions, solo or in combination with other interventions, for non-specific LBP compared with a control group. Trials deemed clinically homogeneous were grouped in meta-analyses. RESULTS Eleven studies were included (n=2,280). In chronic LBP, telehealth interventions had no significant effect on pain at short-term follow-up (four trials: 1,089 participants, weighted mean difference [WMD]: -2.61 points, 95% confidence interval [CI]: -5.23 to 0.01) or medium-term follow-up (two trials: 441 participants, WMD: -0.94 points, 95% CI: -6.71 to 4.84) compared with a control group. Similarly, there was no significant effect for disability. Results from three individual trials showed that telehealth was superior to a control intervention for improving quality of life. Interventions combining telehealth and usual care were more beneficial than usual care alone in people with recent onset of LBP symptoms. CONCLUSION There is moderate-quality evidence that current telehealth interventions, alone, are not more effective than minimal interventions for reducing pain and disability in chronic LBP. To date, modern telehealth media (eg, apps) and telehealth as an adjunct to usual care remain understudied.
Collapse
Affiliation(s)
- Amabile Borges Dario
- Discipline of Physiotherapy, Faculty of Health Sciences, Arthritis and Musculoskeletal Research Group, The University of Sydney, PO Box 170, 75 East St, Lidcombe, NSW 2141, Australia.
| | - Anelise Moreti Cabral
- Discipline of Physiotherapy, Center of Biological Sciences and Health, Federal University of São Carlos, Rodovia Washington Luís, Km 235. Monjolinho, São Carlos, São Paulo, Brazil
| | - Lisandra Almeida
- Discipline of Physiotherapy, Institute of Health Sciences, Federal University of Bahia, Av Reitor Miguel Calmon, Vale do Canela, Salvador, Bahia 40.110-100, Brazil
| | - Manuela Loureiro Ferreira
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Level 13, 321 Kent St, Sydney, NSW 2000, Australia
| | - Kathryn Refshauge
- Discipline of Physiotherapy, Faculty of Health Sciences, Arthritis and Musculoskeletal Research Group, The University of Sydney, PO Box 170, 75 East St, Lidcombe, NSW 2141, Australia
| | - Milena Simic
- Discipline of Physiotherapy, Faculty of Health Sciences, Arthritis and Musculoskeletal Research Group, The University of Sydney, PO Box 170, 75 East St, Lidcombe, NSW 2141, Australia
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, Arthritis and Musculoskeletal Research Group, The University of Sydney, PO Box 170, 75 East St, Lidcombe, NSW 2141, Australia
| | - Paulo Henrique Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, Arthritis and Musculoskeletal Research Group, The University of Sydney, PO Box 170, 75 East St, Lidcombe, NSW 2141, Australia
| |
Collapse
|
50
|
Ames H, Njang DM, Glenton C, Fretheim A, Kaufman J, Hill S, Oku A, Cliff J, Cartier Y, Bosch-Capblanch X, Rada G, Muloliwa AM, Oyo-Ita A, Kum AP, Lewin S. Stakeholder perceptions of communication about vaccination in two regions of Cameroon: A qualitative case study. PLoS One 2017; 12:e0183721. [PMID: 28859101 PMCID: PMC5578665 DOI: 10.1371/journal.pone.0183721] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 08/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Understanding stakeholders' (parents', communities' and health workers') perspectives of communication about childhood vaccination, including their preferences for its format, delivery and content, is an important step towards designing better communication strategies and ensuring more informed parents. Our objectives were to explore stakeholders' views, experiences and preferences for childhood vaccination communication in Cameroon. METHODS In 2014, in the Central and North West Regions of Cameron, we gathered qualitative data for our case study using the following methods: semi structured interviews; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; document analysis of reports and mass media communications about vaccination; and a survey of parents. We conducted a thematic analysis of the qualitative data to identify themes relating to views, experiences and perceptions of vaccination information and its delivery. Survey data were analysed using simple descriptive statistics. RESULTS All of the parents interviewed felt that vaccinating their child was important, and trusted the information provided by health workers. However, many parents wanted more information. Parents did not always feel that they could ask questions during vaccination appointments. All participants felt that health workers and vaccination clinics were important sources of information. Social mobilisation activities such as door-to-door visits and announcements during religious services were important and accepted ways of communicating information, especially during vaccination campaigns. Information communicated through mass media and text messages was also seen as important. In general, stakeholders believed that more consistent messaging about routine vaccination through community channels would be helpful to remind parents of the importance of routine vaccination during ongoing rounds of vaccination campaigns against polio. CONCLUSIONS This study confirms that parents regard information about childhood vaccination as important, but that health services need to be organized in ways that prioritize and facilitate communication, particularly about routine vaccination.
Collapse
Affiliation(s)
- Heather Ames
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
| | - Diangha Mabel Njang
- Department of Anthropology, University of Yaoundé 1, Yaoundé, Central Province, Cameroon
| | - Claire Glenton
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
| | - Atle Fretheim
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Health and Society, University of Oslo, 0318 Oslo Norway
| | - Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Afiong Oku
- University of Calabar, Nigeria, Calabar Municipal, Cross River State, Nigeria
| | - Julie Cliff
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Yuri Cartier
- International Union for Health Promotion and Education, Cedex, France
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Gabriel Rada
- Evidence-based Healthcare Programme, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Angela Oyo-Ita
- University of Calabar, Nigeria, Calabar Municipal, Cross River State, Nigeria
| | - Awah Paschal Kum
- Department of Anthropology, University of Yaoundé 1, Yaoundé, Central Province, Cameroon
| | - Simon Lewin
- Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|